*190104==19999*
DR 0104 (10/07/19)
COLORADO DEPARTMENT OF REVENUE
Colorado.gov/Tax
2019 Colorado Individual Income Tax Return
Full-Year
Part-Year or Nonresident (or resident, part-year,
non-resident combination)
*Must include DR 0104PN
Mark if Abroad on due date – see instructions
Your Last Name Your First Name Middle Initial
Date of Birth
(MM/DD/YYYY) SSN or ITIN Deceased
If checked and claiming a refund, you must include
the DR 0102 and death certicate with your return.
Enter the following information from your current
driver license or state identication card.
State of Issue Last 4 characters of ID number Date of Issuance
If Joint, Spouse’s Last Name Spouse’s First Name Middle Initial
Spouse’s Date of Birth
(MM/DD/YYYY) Spouse’s SSN or ITIN Deceased
If checked and claiming a refund, you must include
the DR 0102 and death certicate with your return.
Enter the following information from your spouses
current driver license or state identication card.
State of Issue Last 4 characters of ID number Date of Issuance
Mailing Address Phone Number
City State Zip Code Foreign Country (if applicable)
Round To The Nearest Dollar
1. Enter Federal Taxable Income from your federal income tax form: 1040 line 11b
or 1040 SR line 11b 1
0 0
Include W-2s and 1099s with CO withholding
.
Additions to Federal Taxable Income
2. State Addback, enter the state income tax deduction from your federal form
1040 or 1040 SR schedule A, line 5a (see instructions)
2
0 0
3. Other Additions, explain (see instructions) 3
0 0
Explain:
(0013)
4. Subtotal, sum of lines 1 through 3 4
0 0
Colorado Subtractions
5. Subtractions from the DR 0104AD Schedule, line 20, you must submit the
DR 0104AD schedule with your return. 5
0 0
6. Colorado Taxable Income, subtract line 5 from line 4 6
0 0
Tax, Prepayments and Credits: see 104 Book for full-year tax table and part-year DR 0104PN Schedule
7. Colorado Tax from tax table or the DR 0104PN line 36, you must submit
the DR 0104PN with your return if applicable. 7
0 0
8. Alternative Minimum Tax from the DR 0104AMT line 8, you must submit the
DR 0104AMT with your return. 8
0 0
9. Recapture of prior year credits 9
0 0
10. Subtotal, sum of lines 7 through 9 10
0 0
11. Nonrefundable Credits from the DR 0104CR line 41, the sum of lines 11, 12, and 13
cannot exceed line 10, you must submit the DR 0104CR with your return. 11
0 0
12. Total Nonrefundable Enterprise Zone credits used – as calculated,
or from the DR 1366 line 87, the sum of lines 11, 12, and 13 cannot exceed line 10,
you must submit the DR 1366 with your return. 12
0 0
13. Strategic Capital Tax Credit from DR 1330, the sum of lines 11, 12, and 13 cannot
exceed line 10, you must submit the DR 1330 with your return. 13
0 0
14. Net Income Tax, sum of lines 11, 12, and 13. Subtract that sum from line 10. 14
0 0
15. Use Tax reported on the DR 0104US schedule line 7, you must submit
the DR 0104US with your return. 15
0 0
16. Net Colorado Tax, sum of lines 14 and 15 16
0 0
17. CO Income Tax Withheld from W-2s and 1099s, you must submit the W-2s
and/or 1099s claiming Colorado withholding with your return. 17
0 0
18. Prior-year Estimated Tax Carryforward 18
0 0
19. Estimated Tax Payments, enter the sum of the quarterly payments
remitted for this tax year 19
0 0
20. Extension Payment remitted with the DR 0158-I 20
0 0
21. Other Prepayments: DR 0104BEP DR 0108 DR 1079 21
0 0
22. Gross Conservation Easement Credit from the DR 1305G line 33, you must
submit the DR 1305G with your return. 22
0 0
23. Innovative Motor Vehicle Credit from the DR 0617, you must submit each
DR 0617 with your return. 23
0 0
24. Refundable Credits from the DR 0104CR line 8, you must submit the
DR 0104CR with your return. 24
0 0
25. Subtotal, sum of lines 17 through 24 25
0 0
Name SSN or ITIN
DR 0104 (10/07/19)
COLORADO DEPARTMENT OF REVENUE
Colorado.gov/Tax
*190104==29999*
26. Federal Adjusted Gross Income from your federal income tax form: 1040 line 8b,
or 1040 SR line 8b 26
0 0
27.
0 0
28.
0 0
29.
0 0
30.
0 0
31.
0 0
32.
0 0
33. Overpayment, if line 25 is greater than line 16 then subtract line 16 from line 25 33
0 0
34. Estimated Tax Credit Carryforward to 2020 rst quarter, if any. 34
0 0
35.
36.
37. Refund, subtract line 34 from line 33 (see instructions) 37
0 0
Direct
Deposit
Routing Number Type: Checking Savings CollegeInvest 529
Account Number
For questions regarding CollegeInvest direct deposit or to open an account, visit CollegeInvest.org or call 800-448-2424.
38. Net Tax Due, subtract line 25 from line 16 38
0 0
39. Delinquent Payment Penalty (see instructions) 39
0 0
40. Delinquent Payment Interest (see instructions) 40
0 0
41. Estimated Tax Penalty, you must submit the DR 0204 with your return.
(see instructions) 41
0 0
42. Amount You Owe, sum of lines 38 through 41 42
The State may convert your check to a one-time electronic banking transaction. Your bank account may be debited as early as the same day received by the State.
If converted, your check will not be returned. If your check is rejected due to insufcient or uncollected funds, the Department of Revenue may collect the payment amount
directly from your bank account electronically.
DR 0104 (10/07/19)
COLORADO DEPARTMENT OF REVENUE
Colorado.gov/Tax
*190104==39999*
Name SSN or ITIN
Lines 35 and 36 are reserved for future use.
If you have an overpayment on line 37 below and would like to donate all or a portion of your overpayment to a qualied
Colorado charity, include Form DR 0104CH to contribute.
Lines 27 through 32 are reserved for future use.
*190104==49999*
Third Party Designee
Do you want to allow another person to discuss this
return and any other information related to this return
with the Colorado Department of Revenue?
No Yes. Complete the following:
Designee’s Name Phone Number
Sign Below Under penalties of perjury, I declare that to the best of my knowledge and belief, this return is true, correct and complete.
Your Signature Date
(MM/DD/YY)
Spouse’s Signature. If joint return, BOTH must sign. Date (MM/DD/YY)
Paid Preparers Name Paid Preparers Phone
Paid Preparer’s Address City State Zip
If you are ling this return with a check or
payment, please mail the return to:
COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0006
If you are ling this return without a check or
payment, please mail the return to:
COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0005
These addresses and zip codes are exclusive to the Colorado Department of Revenue, so a street address is not required.
Name SSN or ITIN
DR 0104 (10/07/19)
COLORADO DEPARTMENT OF REVENUE
Colorado.gov/Tax
File and pay at: Colorado.gov/RevenueOnline